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Whether it’s from a boutique health brand, a jar full of fruity gummies, or a traditional white bottle from your local pharmacy—most Americans take a vitamin every day. In fact, 86% regularly take vitamins, according to an online survey conducted by The Harris Poll on behalf of the American Osteopathic Association. Ninety-seven percent of women take prenatal vitamins or multivitamins during pregnancy, according to a similar survey conducted by The Harris Poll for March of Dimes. But do multivitamins work? Who actually needs these vitamins, and do they improve your health?
For decades, vitamins have been marketed as an easy way to make up for a poor diet and get the essential nutrients your body needs. But the most recent science says that multivitamins—whether they’re a special formulation for women or not—aren’t as good for your overall health as you might imagine. A review of meta-analyses, authoritative reviews, and expert panel reports examining the benefits of vitamin supplementation found insufficient evidence to recommend the use of multivitamins among the general population; in some cases, they can even cause harm. So should you be taking a daily multivitamin for women? The experts say, “Probably not.” Here’s why.
Common ingredients in a multivitamin for women
When you pick up a bottle of vitamins that says “specifically formulated for women,” what does that mean? Is it for bone health or pregnant women?
“Many brands of vitamins marketed toward women will have high levels of certain nutrients that women are commonly deficient in, such as iron or calcium,” says Whitney Linsenmeyer, Ph.D., RD, LD, spokesperson for the Academy of Nutrition and Dietetics and assistant professor of nutrition at Saint Louis University.
But being labeled as “women’s specific” may mean nothing at all. “There is plenty of marketing to suggest that multivitamins for women are distinct from other multivitamins. The reality is that there is no legal or regulatory definition for multivitamins, including those marketed specifically to women.” In other words, women’s vitamins may be no different from other supplements.
Most commonly, women’s vitamins contain a long list of essential vitamins and minerals, including vitamin A, B vitamins (vitamin B6 and vitamin B12), vitamin C, vitamin E, calcium, iron, magnesium, potassium, thiamin, riboflavin, niacin, folate, and biotin. However, vitamins and supplements are not regulated by the Food and Drug Administration (FDA). That means they are not subject to their standards or laws, so ingredient lists and amounts can widely vary. This means that the list of ingredients in each pill may not be present at all or may be in the pill at a much higher amount.
Do vitamins for women really work?
Most physicians and scientists do not suggest a daily multivitamin for the following reasons.
There’s not strong evidence of benefits.
Even as early as 2006, the National Institute of Health said there wasn’t enough evidence to recommend taking multivitamins. Additionally, an editorial that accompanied a 2013 study published in the Annals of Internal Medicine was pretty straightforward with the title: “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.”
Many experts take a definitive stance on supplements, stating that most people should stop spending their money on multivitamins after seeing study after study prove their benefit to be small, or nonexistent—especially for postmenopausal women. A Women’s Health Initiative study found that postmenopausal women who took multivitamins did not have a lower death rate than others and were just as likely to develop cardiovascular disease or cancers of the lung, colon, rectum, breast, and endometrium—these results that are consistent with findings from a plethora of other studies.
Vitamins could be harmful.
Surprisingly, some research finds that not only are multivitamins a waste of money, but they are also a hazard to your health. “The quantity of vitamins and minerals in any supplement is important, especially when considering the risk of exceeding the upper limit intake of a given nutrient—as this may pose a risk for toxicity, which can have significant adverse health effects,” Linsenmeyer says. “Consumers are encouraged to not exceed the recommended dosage, and to work with their physician and/or registered dietitian to ensure they are not at risk for toxicity or any adverse interactions with other foods or medications.”
“Certain vitamins and minerals can impact the absorption of medications, either inhibiting the absorption or increasing it,” Willow Jarosh, MS, RD, and owner of Willow Jarosh Nutrition in New York City, says. “In addition, some supplemental nutrients can have similar effects to medications—so if you’re taking a medication that, say, thins the blood and also taking a multivitamin that has a mild blood thinning effect, that could compound the effects.”
It’s best to get nutrients from food.
That’s why most health experts, nutritionists, and dietitians recommend getting your vitamins and minerals from the food you eat. “I follow a food-first philosophy, meaning it is ideal to get the nutrients you need through whole foods,” Linsenmeyer says. “This is because the nutrients in whole foods are often better absorbed than in supplement form. Whole foods contain other beneficial compounds beyond just vitamins and minerals—such as phytochemicals and fiber, and there is low risk for consuming micronutrients in excess from whole foods.”
To satisfy your body’s nutritional needs with food, try incorporating this list, recommended by Harvard Health, into your diet:
- Avocados
- Leafy vegetables like chard, collard greens, kale, mustard greens, spinach
- Bell peppers
- Brussels sprouts
- Mushrooms (cremini and shiitake)
- Baked potatoes
- Sweet potatoes
- Cantaloupe, papaya, raspberries, strawberries
- Dairy products, such as low-fat yogurt
- Eggs
- Seeds (flax, pumpkin, sesame, and sunflower)
- Dried beans (garbanzo, kidney, navy, pinto)
- Lentils, peas
- Almonds, cashews, peanuts
- Whole grains such as barley, oats, quinoa, brown rice
- Salmon, halibut, cod, scallops, shrimp, tuna, sardines
- Lean beef, lamb, venison
- Chicken, turkey
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However, there are exceptions to the rules—as is the case with women who are pregnant or lactating, and populations that are at risk for a vitamin or mineral deficiency. In these special circumstances, dietary supplements are routinely recommended. Because half of all pregnancies are unplanned, it is suggested that all women of childbearing age take a folic acid-containing prenatal vitamin.
What supplements should women take?
The Office on Women’s Health, a branch of the U.S. Department of Health and Human Services, recommends these vitamins for women:
Though the amount needed varies by age, health, and diet.
Folic acid/folate (vitamin B9) for preconception and pregnancy
“Folic acid is a good idea for people who are planning on becoming pregnant,” Jarosh explains. “Having sufficient intake of this nutrient can help prevent neural tube defects in babies.” The Centers for Disease Control and Prevention recommends that women of reproductive age get 400 micrograms (mcg) of folic acid daily to prevent birth defects even if you’re not pregnant. Though the recommended amount rises to 4,000 mcg if you become pregnant or have a family history of spina bifida, according to the Office on Women’s Health.
There are some exceptions, one being “people who have a genetic variation—called MTFHR—might have trouble converting folic acid into a form of folate that their body can use,” explains Jarosh. These patients should discuss with their physician the type and amount of folic acid that is best for their situation. Folic acid can also interact with necessary medications for epilepsy, diabetes, lupus, and rheumatoid arthritis.
“I think folic acid is a great example of the idea of taking the nutrients that you need as an individual, but that supplementation isn’t necessarily something that is one-size-fits-all or something that we all need to do,” says Jarosh. “Genetics, lifestyle, food choices, and health status all factor into whether a person needs supplements and which ones they need.”
Vitamin B-12 for all adult women
Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy. The National Institutes of Health recommends that adult women get 2.4 mcg of B12 daily. That amount rises to 2.6 mcg during pregnancy, and 2.8 mcg while breastfeeding.
Those who are deficient in it are often incredibly fatigued and weak—and there are plenty of reasons why someone could be deficient. “Older people might not be able to absorb as much B12 from food, while vegans or vegetarians may have trouble getting enough because B12 is found naturally in animal products,” Jarosh explains.
Certain health conditions can also impact vitamin absorption. “People who have digestive diseases like celiac disease or Crohn’s disease may have trouble absorbing enough B12 from food. Same goes for people who have had GI surgeries including weight loss surgery. There’s also a condition called pernicious anemia in which a person doesn’t make intrinsic factor—so they can’t absorb B12. All of these conditions and circumstances would warrant a person having some sort of B12 supplement.”
Vitamin D for all adult women, but especially older women
The National Institutes of Health recommends that adults get 15 mcg (600 IU) of vitamin D daily. After age 70, that amount increases to 20 mcg (800 IU), which can be difficult if you wear sunscreen (you should!), spend most of your time indoors, or have a vitamin D deficiency. In those cases, a supplement can be helpful. Also, if you are a breastfeeding, you can take 6000 IU a day yourself and increase your own vitamin D levels and boost the amount in your breast milk.
Calcium for postmenopausal women
Some doctors may suggest that women take calcium supplements, which can be essential in preserving strong bones—especially in postmenopausal women. The recommended amount varies by age from 1,000 mg to 1,300 mg, according to the Office of Women’s Health. Studies suggest that most women do not get the recommended daily value of calcium daily from their diet, which could lead to osteoporosis or other health problems.
Iron for pregnancy and anemia
Iron is recommended when your red blood cell count is low or at risk of becoming low—for example, if you are anemic. But there are other cases in which supplemental iron is needed for women. According to the office of Women’s Health, the amount you need throughout your life is:
- Ages 19 to 50: 18 mg
- During pregnancy: 27 mg
- Ages 51 and older: 8 mg
“In addition to women with or who are prone to anemia, iron will often be prescribed to women who are pregnant,” Jarosh says. “During pregnancy, blood volume increases and along with this iron needs increase—so supplemental iron is often recommended.” Just be sure to talk to your healthcare provider before taking a supplement. It’s important to find out what’s causing low red blood cell counts before treating anemia, according to Jarosh.
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Talk to your healthcare provider
The vitamins—and dosages—you need are based on your age and health conditions, such as pregnancy. “Some [daily reference intake] recommendations do not vary dramatically; for example, vitamin D needs for women remain fairly constant from childhood through adulthood, regardless of pregnancy or lactation,” says Linsenmeyer. “Others change quite a bit throughout the lifespan, such as iron needs that more than double during a woman’s childbearing years and more than triple during pregnancy.”
In other words, there’s no one-size-fits-all solution for getting the nutrients you need for optimal health. If you are concerned about a vitamin deficiency, consult your physician about what appropriate supplementation could look like. It’s different for everyone, so it’s likely one tablet can’t solve all of our needs.
